Colon Cancer Screening
Colon cancer is the third most common cause of cancer deaths in the United States. The colon cancer comes from colon polyps (benign growths) that degenerate over time to cancer. Cancer can be prevented in most cases by removing polyps before they transform to cancer, and then following those patients with colonoscopy every few years.
Twenty-five percent of people in the United States will make polyps in their lifetime. Most polyps will be evident by age 50 (and over). For this reason, screening colonoscopy is recommended after age 50. Since polyps don’t cause pain or symptoms, colonoscopy is recommended just because of age, just as Pap tests, mammography and prostate exams are recommended.
Colonoscopy is an outpatient test whereby the patient is sedated, and a flexible tube is inserted into the entire 4-5 feet of colon. As a result of the sedative, the patient should not experience any discomfort during the procedure. If polyps are present, they are removed at that time. If no polyps are seen, the next colonoscopy would be performed in 10 years.
If there is a family history of mother, father or siblings with colon polyps or cancer prior to age 60 then colonoscopy is recommended every 5 years beginning 10 years before the age that family member had cancer.
Colonoscopy takes 20-30 minutes to perform, and it is uncommon for the patient to remember the test because of having been sedated. The preparation the day before includes a liquid diet and a small laxative dose twice during that day. The patient will not be able to drive, therefore someone to drive the patient will be required the day of the exam. Aspirin and many arthritis medicines and blood thinners such as Coumadin and Plavix should be stopped before the test. The length of time should be determined by your doctor.
Colonoscopy is the only test that can diagnose polyps or cancer, and be therapeutic, by removing or biopsing these lesions.
Once polyps are found, follow-up colonoscopy will be ordered every 3-5 years, depending on the number and size of polyps found. These are the current recommendations.
The risks for this procedure are minimal in our hands. We have not experienced perforations or bleeding after colonoscopies. Rarely, the scab from the site of a resected polyp will fall off prematurely, and there may be bleeding 2-5 days after a procedure. This is not preventable. Overall colonoscopy is a safe and effective test to find and remove colon polyps, and prevent future cancers.